Missing Guidewire in a Bulla: A Case Report
The incidence of a missing guidewire during the Seldinger technique is low but can occur due to procedural errors. Reported rates vary, ranging from 0.1% to 0.8% in central venous catheterization and other vascular access procedures. We present a rare case of a retained guidewire within a pulmona...
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| Format: | Article |
| Language: | English |
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Korean Society for Thoracic & Cardiovascular Surgery
2025-07-01
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| Series: | Journal of Chest Surgery |
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| _version_ | 1839646212310958080 |
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| author | Hee Chul Yang Sarah Nisivaco Chitaru Kurihara |
| author_facet | Hee Chul Yang Sarah Nisivaco Chitaru Kurihara |
| author_sort | Hee Chul Yang |
| collection | DOAJ |
| description | The incidence of a missing guidewire during the Seldinger technique is low but can occur
due to procedural errors. Reported rates vary, ranging from 0.1% to 0.8% in central venous
catheterization and other vascular access procedures. We present a rare case of a retained
guidewire within a pulmonary bulla following Seldinger-based chest tube insertion in a
patient with ventilator-induced pneumothorax. Due to a prolonged air leak, the guidewire
was removed, and wedge resection of the affected lung parenchyma, along with talc pleurodesis,
was performed via video-assisted thoracoscopy. Closed thoracostomy using the
Seldinger technique requires caution in emphysematous patients receiving mechanical
ventilation. To facilitate lung deflation and minimize the risk of lung injury during needle
and guidewire placement, the endotracheal tube can be temporarily disconnected from
the ventilator. Over-insertion of the wire and dilator should be avoided. Supervision and
simulation training are crucial to prevent this type of “never event.” |
| format | Article |
| id | doaj-art-fed28db1e02d4b3abfa9c05c20cd93ff |
| institution | Matheson Library |
| issn | 2765-1606 2765-1614 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Korean Society for Thoracic & Cardiovascular Surgery |
| record_format | Article |
| series | Journal of Chest Surgery |
| spelling | doaj-art-fed28db1e02d4b3abfa9c05c20cd93ff2025-07-01T02:41:23ZengKorean Society for Thoracic & Cardiovascular SurgeryJournal of Chest Surgery2765-16062765-16142025-07-0158415715910.5090/jcs.25.023Missing Guidewire in a Bulla: A Case ReportHee Chul Yang0https://orcid.org/0000-0003-2605-5985Sarah Nisivaco1https://orcid.org/0000-0003-4448-9023Chitaru Kurihara2https://orcid.org/0000-0003-3536-4675Division of Thoracic Surgery, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL, USADivision of Thoracic Surgery, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL, USADivision of Thoracic Surgery, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL, USAThe incidence of a missing guidewire during the Seldinger technique is low but can occur due to procedural errors. Reported rates vary, ranging from 0.1% to 0.8% in central venous catheterization and other vascular access procedures. We present a rare case of a retained guidewire within a pulmonary bulla following Seldinger-based chest tube insertion in a patient with ventilator-induced pneumothorax. Due to a prolonged air leak, the guidewire was removed, and wedge resection of the affected lung parenchyma, along with talc pleurodesis, was performed via video-assisted thoracoscopy. Closed thoracostomy using the Seldinger technique requires caution in emphysematous patients receiving mechanical ventilation. To facilitate lung deflation and minimize the risk of lung injury during needle and guidewire placement, the endotracheal tube can be temporarily disconnected from the ventilator. Over-insertion of the wire and dilator should be avoided. Supervision and simulation training are crucial to prevent this type of “never event.”emphysemapneumothoraxseldingerchest tubesthoracostomycase reports |
| spellingShingle | Hee Chul Yang Sarah Nisivaco Chitaru Kurihara Missing Guidewire in a Bulla: A Case Report Journal of Chest Surgery emphysema pneumothorax seldinger chest tubes thoracostomy case reports |
| title | Missing Guidewire in a Bulla: A Case Report |
| title_full | Missing Guidewire in a Bulla: A Case Report |
| title_fullStr | Missing Guidewire in a Bulla: A Case Report |
| title_full_unstemmed | Missing Guidewire in a Bulla: A Case Report |
| title_short | Missing Guidewire in a Bulla: A Case Report |
| title_sort | missing guidewire in a bulla a case report |
| topic | emphysema pneumothorax seldinger chest tubes thoracostomy case reports |
| work_keys_str_mv | AT heechulyang missingguidewireinabullaacasereport AT sarahnisivaco missingguidewireinabullaacasereport AT chitarukurihara missingguidewireinabullaacasereport |